Question Easy:
A 28-year-old woman presents with fatigue, weight gain, and cold intolerance. On examination, she has dry skin and bradycardia. Blood tests reveal low free T4 and elevated TSH. What is the most likely diagnosis? 🌡️
A) Hyperthyroidism
B) Addison’s disease
C) Hypothyroidism
D) Cushing’s syndrome
E) Pheochromocytoma
Question Medium:
A 56-year-old man presents with weakness of his right hand and difficulty speaking. His speech is slurred but he can understand others. An MRI indicates a lesion in the brain. Which artery is most likely occluded? 🧠
A) Anterior cerebral artery
B) Middle cerebral artery
C) Posterior cerebral artery
D) Basilar artery
E) Vertebral artery
Question Hard:
A 35-year-old male presents with episodic headaches, palpitations, sweating, and hypertension. Further biochemical tests show elevated catecholamines in urine. Which genetic condition is most commonly associated with this presentation? 😰
A) MEN type 1
B) MEN type 2A
C) MEN type 2B
D) von Hippel-Lindau syndrome
E) Neurofibromatosis type 1
Explanations & Answers:
Question Easy Answer: C
Question Easy Explanation: This patient’s symptoms and laboratory results are characteristic of hypothyroidism, where there’s low production of thyroid hormones (resulting in low T4) and a compensatory increase in TSH. NICE guidelines recommend considering hypothyroidism in patients with such symptoms and blood test results.
Question Medium Answer: B
Question Medium Explanation: The middle cerebral artery supplies regions of the brain responsible for motor and sensory functions as well as speech. Occlusion here is commonly associated with weakness, particularly on one side of the body, and speech difficulties, aligning with the symptoms of this patient.
Question Hard Answer: B
Question Hard Explanation: Pheochromocytomas, which present with the described symptoms and elevated catecholamines, are most commonly associated with Multiple Endocrine Neoplasia (MEN) type 2A. It is recommended by NHS guidelines to consider genetic testing in such cases to confirm the diagnosis.
Medical fact of the day: In the UK, the prevalence of subclinical hypothyroidism is around 8% in women and 3% in men, with risk increasing with age. Regular screening in high-risk populations is recommended to prevent progression to overt hypothyroidism and associated complications.
Quote of the day: “In the quest to heal others, remember that every small step counts, and each challenge faced is a step towards growth.” 🌟